Technologies of trust in epidemic response: openness, reflexivity and accountability during the 2014-2016 Ebola outbreak in West Africa
Technologies of trust in epidemic response: openness, reflexivity and accountability during the 2014-2016 Ebola outbreak in West Africa
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DOI：
10.1136/bmjgh-2018-001272
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发表时间：
2019-02-01
影响因子：
8.1
通讯作者：
Graham, Janice E.
中科院分区：
文献类型：
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作者：
Ryan, Molly J.;Giles-Vernick, Tamara;Graham, Janice E.
信任是成功的合作努力的一个重要组成部分。2014-2016年西非埃博拉疫情的全球卫生应对面临着历史上脆弱的区域信任关系。在流行病期间，混乱的社会政治背景和最初不适当的沟通战略阻碍了社区和应对者之间的可信赖关系。隶属于埃博拉100-巴斯德研究所项目的社会科学家采访了大约160名在疫情期间担任各种角色的地方、国家和国际应急人员。本质性研究以疫情期间社区信任的反应者经验为重点，识别并探讨有效应急反应的社会技术。应对措施需要具有不同知识和经验的个人。响应者包括现场的社会动员者、卫生工作者和临床医生、政府官员、救护车司机、接触者追踪者等等。我们发现，信任是通过开放、透明和反思性的沟通来培养的，这种沟通是适应社区主导的应对努力和实时优先事项的，并对此负责。我们扩大这些研究结果，以确定“信任的技术”，可用于促进积极合法的值得信赖的关系。答复者采用开放性（愿意并真正努力纳入多种观点）、自反性（灵活应对背景和持续对话）和问责制（对当地背景和后果负责）等社会技术来促进信任关系。信任技术有助于制定一个实用技术框架，以提高未来应急战略的接受程度和有效性
Trust is an essential component of successful cooperative endeavours. The global health response to the 2014-2016 West Africa Ebola outbreak confronted historically tenuous regional relationships of trust. Challenging sociopolitical contexts and initially inappropriate communication strategies impeded trustworthy relationships between communities and responders during the epidemic. Social scientists affiliated with the Ebola 100-Institut Pasteur project interviewed approximately 160 local, national and international responders holding a wide variety of roles during the epidemic. Focusing on responder's experiences of communities' trust during the epidemic, this qualitative study identifies and explores social techniques for effective emergency response. The response required individuals with diverse knowledges and experiences. Responders' included on-the-ground social mobilisers, health workers and clinicians, government officials, ambulance drivers, contact tracers and many more. We find that trust was fostered through open, transparent and reflexive communication that was adaptive and accountable to community-led response efforts and to real-time priorities. We expand on these findings to identify ` technologies of trust' that can be used to promote actively legitimate trustworthy relationships. Responders engaged the social technologies of openness (a willingness and genuine effort to incorporate multiple perspectives), reflexivity (flexibly responsive to context and ongoing dialogue) and accountability (taking responsibility for local contexts and consequences) to facilitate relations of trust. Technologies of trust contribute to the development of a framework of practical techniques to improve the acceptance and effectiveness of future emergency response strategies